- Terms of Reference:
The intention of this report is to use theories and strategies relevant for pursuing enhanced effectiveness and good governance in the management of a health and social care organisation. The desired outcome will be to achieve gradual transformation of the care management and social care provision of the service. Rather than producing total transformation which had not worked in the past, this report will focus on particular aspects of the transformation, explaining how this can be carried out.
- Introduction and context
I was on placement for an integrated health and social care community team in a London Borough. My specific area was in a Learning disabilities team. The total number of service units under adult community care is 11 (including day centres and residential care) with an aggregated annual budget of £7 million. This includes a day centre run by health services under the integrated services scheme that was created under the Joint Investment Plan. The overarching vision is to promote independence and choice for service users through a range of services both to prevent the need for costly health and social care services, and maximise the potential for each individual to have fulfilling lives, which is the basis for efficiency and good governance.
The challenge that will be the topic of the assignment will be to consider external and internal factors in bringing about individualised budgets for service users under the transformation agenda. The purpose will be to properly ensure that service users are in control of their service provision by giving them the power to direct how their support package will be spent, and wider choices on who will assess their needs and provide the support. This poses a challenge to the current arrangement as it may lead to fundamental changes in staffing arrangements, reducing the current staffing levels, encouraging staff to work in new ways and delivering a modern fit for purpose quality service.
- Research Methodology
This project will be researched comparing theories, models and techniques to bring about the desired change in organisational transformation. Examples will be sourced from the local authority where I had a previous placement. The key concepts which will be used in the project will involve leadership, partnership, team working and change management theories derived from national health and social care policies. The focus will be on social care in general and learning disabilities specifically. It will be necessary at this juncture to critically explain some organisational concepts. In terms of applying change management strategies, knowledge of organisational culture is important. Culture is the informal psychology and social aspects of an organisation which influences how people think, what they see as important and how they behave and interact at work (Mannion et al, 2005). Organisational culture influences the performance of health and social care organisations. On the other hand, organisational culture is a metaphor used to inform management. (Morgan 1986). The key methodological principle in studies of organisational culture is to investigate organisations as mini societies (Ashkanasy and Jackson, 2001). Institutions are linked to systems and organisations (North, 1990). There are external and internal institutions: internal is customs, ethical norms and manners where violations are dealt with informally, while external are agents where a political process delegates them to legitimately enforce (Kasper and Streit, 1998). The choice over the most efficient institutional structure for the production of a service is linked to the ease by which outputs can be measured and the degree of clarity of understanding of the transformation process by which inputs are transformed into outputs. This will be viewed further in the course of the project.
An effective change management tool is project management. Dyer et al (2004) provides an analytical framework that organisations and managers need to run successful projects for the right outcomes in a way which enhances the overarching purpose or strategy of their organisations. In project management a good idea is turned into a successful outcome. Rosenau (1998) sees projects as needing to meet specifications to finish on time and complete objectives within budget. In the organisation I am viewing, Projects are carried out by consultants but, Dyer et al (2004) says it can be done in-house. So project management is a set of tools and methods designed to enable organisations plan manage and achieve one off goals. It is used mostly to do with the pace and scope of change. It drives the development process as services become more complex. Walker (2001) states that people are now working more in partnerships. Meridith and Mantell (2000) talked about one of the first project management tool, the Gantt chart. In the 1950s other tools emerged such as Du Pont’s critical path method and the programme evaluation and review technique (Perce, 1998). Projects can get external funding, for a range of issues such as developing new service delivery models, outsourcing support services, quality improvement initiatives and organisational change is always a constant underlying theme.
Good management and leadership are required to effect change in organisations. The term leadership and management may be a confusing one. Managers have formal authority to direct the work of others, being responsible for the quality of that work and the costs of achieving it. While you do not need to be a manager to be a leader, you need to be an effective leader to be a good manager (Barr and Dowding, 2008)?
- Main Findings
4:1 Current Situation
The organisation heralded its transformation programme in 2007 in response to Valuing People Now (DH, 2007) and Our Health, Our Care, Our Say (DH, 2006) and Putting People First (2007). Government, local authorities, health authorities, professional bodies and voluntary organisations agreed to the strategy and on the necessity of replacing the existing model of social care delivery. The Local authority pinned its transformation agenda on seven key elements: Establishing Self Directed Support (SDS), Redesign of Care Management and Assessment, Commissioning, making staffing efficiency savings, modernising day care, modernising transport and developing alternatives to residential care.
The local authority made attempts to set up a framework for organisational development along the lines of Building and nurturing an improvement culture (DOH, 2005), which stated that every organisation has four cultures, written, unwritten, a culture the organisation needs and one that it wishes existed. It has tried to foster clear leadership in establishing its culture, behaviour and systems in delivering its transformation programme. It believes it already has the foundations for ensuring successful organisational change and improvement. On paper, it recognises leadership is not just with senior management but has different forms and sources, recognising that all team managers has a leadership role to play, staff provide operational and professional expertise, while service users are experts by experience. But in reality the organisational leadership structure runs from top to bottom, rather than a partnership framework. For instance, the Transformation Board was made up entirely of senior managers. In 2008 senior management tried to enforce its own model of transformation which displeased carers and service users and led to a halt in the transformation programme. After this, the organisation decided to establish a more person-centred approach by revisiting Valuing People (DH, 2001) for those with learning disabilities. After establishing a new assessment framework and support plans under the Self Directed Support model, service provision was expected to be led by what service users stated in their support plans. The reassessments were completed in 2009, and led to the present stalemate, as service users clearly voiced their intentions to care management review officers that they wanted to keep their current day centre provision, while senior management were hoping to make efficiency savings by selling one or two of the day centres.
It was initiated as part of its organisational development plan team away day’s management away day’s service user conferences in order to raise awareness. While developing its transformational programme, the local government recognised that initially this may not fall within expected timescales, and may not be delivered within current resources. The senior management driver with regards the transformation was to make efficiency savings (on staffing, resources and services) with raising quality and standards a paper exercise. Efficiency staff savings of 250 staff is currently being made within the local authority leading to a saving of £50 million by 2011. Dyer et al (2004) saw global huge pressures on resources, organisations having the potential to advance the quality of people’s life, old ways of funding, administrating and managing health and social services are swept away in a wave of change since the 1980s. Managers and professionals have found new ways of providing care and doing business. Gains in effectiveness and sustainability have been made, but hard to bring new methods into practice.
4:2 Desired Options
The desired option of the organisation is ensuring 50 per cent of service users have SDS by 2011 among physical disability, older people and learning disability services. The local authority Circular (DH, 2008) laid down guidance on how services were to be redesigned and reshaped. In terms of efficiency and good governance, the objective is to improve outcomes for vulnerable people and deliver cashable efficiencies. As the organisation has already mapped out and are delivering on the reduction of staff this report will concentrate on improvements for vulnerable people in general and learning disabilities in particular. The SDS will be expected to improve existing institutional day care and produce community based solutions focusing upon user centred outcomes including education, employment, leisure and support for carers. This can be achieved through partnership working where delivery of services with other providers and the development of niches for the range of services offered to service users and carers can be applied.
Producing effective teams is also important. Staff need to develop their knowledge and skills to support service users. An organisation which has to adapt quickly to its changing competitive, economic or social environment will rely on good teamwork so that it can pool resources and respond quickly to new opportunities or threats. To be successful a team need to ensure it is constantly at the performing stage of Tuckman’s stages of group development (Mullins, 1993). The characteristics of a performing team have team spirit as an underlying feature. This is evidenced if members of the group are committed, dependent on each other, resolve conflicts themselves, and can express them openly. The outcome will assist service users to improve the quality of their lives, developing more effective and efficient ways of supporting service users.
The major platform for this personalisation agenda is Self Directed Support (SDS). The underlying principle for SDS began with In Control as a social justice movement in 2003 to reform the social care system and promote citizenship (In Control, 2003). The key components of SDS are a personalised support plan that reflects an individual’s ambition for their life based on an early indication of the available budget. Second, is simplifying the assessment process to spend less time on information, and more focus on the individual’s input where possible. Another principle is transparency. It should be clear to each individual how much money has been allocated to them to spend on there care and support packages. A third component is to empower individuals to use their personal budget to get the right support and a better lifestyle.
The allocation of a personal budget is the key component of SDS and is based on a self assessment of a person’ needs. How the individual intends to spend their money is up to them. The support plan and budget can be managed in a number of different ways which includes direct payments or managed by the local authority. In-Control believes people who require social care support can control their own lives and become full citizens. They call it a professional “gift model” needing to evolve into a citizenship model (In control, 2003). Likewise, SDS is the name given to a way of redesigning the social care system so that the people who get services can take control over them. Direct payments and individual budgets gives people the opportunity to control the resources allocated to their support. The underlying principle of SDS is also to enable people make decisions and manage their own risks. DH (2007)
In terms of applying risk management to SDS and the personalisation agenda, Oldham’s Risk Enablement panel, REP (2007) will be provided as a good example. The REP gives advice and support to staff to ensure risks with high repercussions are minimised and managed to protect staff and service users. REP has been designed to be a safe and supportive environment for both the individual and staff. No individual is left to make a difficult decision. In terms of risk management, the support plan should be done in a manner that keeps the person safe. If it places the person in a position of abuse or harm then referral to the REP can be made. If the risk is significant then the support plan is refused. Some risk assessment requiring REP will be the more complex risks such as complex health care needs, complex challenging behaviours, moving and handling, physical intervention, or complex risk assessments involving family, carers and the community, health and safety issues, require isolation, have forensic needs. Councils will have to strike the right balance between giving people the freedom to choose their own care and protecting people and their budgets from abuse. (Community care, 2009)
The issue of capacity in terms of SDS and the personalisation agenda is crucial. This is because although people are expected to take control of their lives, some may not be able to do so without support. There are five key principles of the Mental Capacity Act that affects SDS and the personalisation agenda. When people do not have the capacity to make decisions, these must be made for them, but must be in their best interest, and such decision must be the least restrictive option for their basic rights and freedom. Also, people are allowed to make unwise decisions, because it is the process by which the decision is reached that determines if capacity is absent. All practical steps must then be taken, such as giving sufficient time for assessments; repeating assessment if capacity is fluctuating, and using the relevant communication method of the person such as pictures, sign language and interpreters. So a person’s ability to make decisions must be improved before concluding that capacity is absent. Finally, assumptions of lack of capacity should not be made. These assumptions include the person’s diagnosis, behaviour and appearance (Crown, 2005). So capacity is decision specific. Where people lack capacity consulting families and friends will be important.
Bennet (2008) states that the Health and Social care bill (2007 / 2008) seeks to ensure that those lacking capacity are not excluded from the options available to others, including direct payments (DP). CSCI (2006) identified a number of barriers as to why the initial take up of DP was low and its impact not significant. These included lack of clear information, processes were somewhat bureaucratic. (DH, 2007) suggested that one way of overcoming the barrier was that DP should be done through local user led organisations. I will meet with the person to establish what he understands about SDS/DP and how it may help them. Also, explaining how payments will be made such as cash, cheques or invoices. There may also need to be follow up meeting (with user and or family members, advocate, circle of support) to establish what activities or help the person may wish to receive.
There are a number of implications of SDS and Personalisation for social work and care staff. The role will change because they will need to form new, more equal relationships with the people they support. For many care managers this will mean a return to doing social work (DH, 2008). Care managers as purchasers of services would normally broker the amount for the person. Now the allocation of resources has to be made transparent. The role of care managers will now be more of advocacy and brokerage rather than assessment and gate keeping. This is a move away from the model of care where a person receives care determined by a professional to one that has person centred planning at its heart, with the individual firmly at the centre in identifying what is personally important to deliver his or her outcomes (DH, 2008).
A support broker will act independently of the council’s social services, and is directed by the individual to access an assessment of their care needs, puts together a support plan (not care plan) obtain or negotiate and manage funding to pay for the care service, implement plans, monitor and evaluate the service, build personal networks, mediate and resolve problems and provides help and advice. The care manager will still work with the person who undertakes the needs assessment, and act as lead professional to case manage the care package. There should be an assumption of capacity rather than assuming that everyone will need a broker.
In fact, people and their families will be best placed to act as brokers. So there is a change in power relationships where people are contributors and partners rather than dependent recipient. This model would reduce the role of social workers and care managers, and broaden the market of social care services, on the assumption that providers will react to the purchasing power of individuals rather than social services. While CSCI acknowledged the difficulty in recruitment and retention of staff into a new role which resembles a lot of the care management function, they were unclear as to who would best fill this role, stating that current care managers could be involved in a conflict of interests if they took on the role as support brokers because their role includes rationing services (community care, 2009). This may then require care managers to work independently of social services.
Behavioural and attitudinal change need to be demonstrated by staff and managers. Kennedy (2001) criticised “club” culture which focused excessive power and influence around a core group of senior managers, which fostered a climate where dysfunctional behaviour and malpractice were not effectively challenged. Mannion et al (2005) found out that the important ingredients of high performing establishments are good leadership, empowered middle managers, high quality information systems, and an active human resource function which provides the foundation. Senior leaders of an organisation challenge the way things are done in the organisation. They value the importance of team work, recognising the importance of it in order to deliver culture change and understand the impact that group dynamics can have on enabling or inhibiting team effectiveness. Some of the issues aimed at improving performance include restructuring, centralisation, competing purchasers, decentralisation and markets. But these are seen as contradicting each other, leading to a situation where interventions are made without time spent on diagnosis.
Where outputs are measurable and knowledge of the transformation process is imperfect, it may be more efficient to gather information from a market system. Where output is not measurable but knowledge of transformation is good, knowledge of the behaviour of those involved in the transformational process is the key informational requirement. The most efficient mode of control will be the use of hierarchical institutions that rely on rules, target, monitoring by superiors over subordinates, such as the use of performance indicators and ensuring adherence to guidelines. Being able to measure outputs and good knowledge of transformation would mean the markets and hierarchies are the best form of governance. But where neither output can be measured nor knowledge of transformation is low, social and cultural controls are important. This leads to clan culture. A mechanistic organisation sees tasks allocated, authority delegated, communication channelled and the whole enterprise seen in terms of coordinating and rationing out of work.
4:3 Applying the desired options
One of the key tools I will use in applying the desired option is the project management tool. Dyer et al (2004) said that large organisations found it hard to balance what is achievable, and external as well as internal impacts needed to be considered. Properly used it can help an organisation grow. Managing and predicting change is hard. Sometimes, when money is used up, the project becomes unsustainable. Van Eyk et al, (2001) did not look favourable at project management as it is dominated by the need to cut costs. They fail when they are at odds with the organisational culture or require unwelcome change in work practices, power relations or working together. This has largely been a problem in my organisation. The project design must therefore include the size and scope of the change management component. One mismatch is small budgets and large goals which invariably lead to project failure. I will project manage this change as it will save money that has been overspent on consultants.
The type of change I will be proposing to initiate will be one that will effectively gain acceptance and engagement of the change. However, this will be harder since the change expected is a transformational, while the literature expects transitional and development changes to be easier (Tucker, 2007). Developmental change is for improvements to current practices, transitional will replace practices with something new, while transformational occurs after the transition period. There are a number of management tools that can be applied to bring about change. Some of these include mapping out a systems analysis of the organisation, Nadler and Tushman’s model of shared vision and leadership, and Lewin’s forcefield analysis. However, I will be using the PESTEL and SWOT analysis as these tools are readily known to the team and the organisation.
Impacts from the external environment are one of the best explanations for a transformation. This can be explained by carrying out a PESTEL (external) analysis. This will also require a SWOT analysis to consider how the organisation’s strategies fit with its external environment. The organisation will then be able to profit from its strengths and opportunities and shield itself against weaknesses and threats (Adams, 2005). However, De Witt and Meyer (1998) believe that there are other more advanced modern strategic theories such as trade offs. This project will use SWOT for its simplicity, and the fact that the transformation agenda has already gone through its birth pangs (since 2007), and may be ready to take the next step as external factors loom. The SWOT analyses in appendix 2 demonstrates that while there are well experienced and skilled staff, demotivation has set in because the transformation has been long drawn out with few decisions made: this is an area to resolve. However, there are opportunities for enthusiastic staff to learn new skills and work in new and innovative ways. It is also clear from PESTEL that the transformation is gathering pace as a result of economic and political factors in appendix one. As a result of this the change now becomes viable and the organisation must place itself in a position where it can deal with the threats coming from the external environment and tale advantage of the opportunities that may arise, fully utilising its strengths.
Appendix 3 demonstrates how the right environment is created to enable a change to take place, using Lewin’s three change process (Lewin, 1951) to guide the target audience through the change process. I would recommend that since the personalisation programme is relatively new, it is essential to continue with informing people to understand the new ideas such as holding workshops, seminars and conferences and inviting family members who from my experience tend to get less involved due to some of their beliefs of seeing services more in terms of respite. Staff training and staff reduction is an essential part of this process which Lewin calls unfreeze. Then apply the change once people have developed the awareness and skill to carry it out. Drivers can be used to push the change through by highlighting those staff, service users and parent and carers keen on the change; then refreeze to reinforce the change (Lewin, 1951). The refreeze stage can be embedded by applying new policies and procedures, guidelines on how to work within the new system such as the new operational or business plan, new job descriptions for staff and managers (appendix 3). I have found that this change process easily explains how change can take place, explained in an easy simple fashion.
There are three strategies which can be used to facilitate change. Empirical rational suggests that if the change is good people will adopt it. Then, the power coercive approach relies on change through legislation, national policies and senior managers influencing people to change (House, 1981). Finally, the normative reductive model, demonstrates that the individual must take part in their re-education if they are to change. They can be guided along by trainers or supporters, who may act as change agents. Managers and enthusiastic staff can play this role. (Chin and Benne, 1969). (Sashkin and Egermeier (1992) counterbalances these arguments by stating that House (1981) attempts at technological (empirical rational), political (power-coercive) and normative re-educative (cultural change) phases will succeed best if the parts, the people and the service is fixed. For instance, people are fixed through training and development, which is the current stage of the organisation, where power moves from top down. Chin and Benne’s (1969) original work will be adopted.
Past experiences have demonstrated that power-coercive approaches on its own, as guided by senior managers have not worked. However, the external environment (economic and political) is demonstrating that legislation and policy changes are becoming strong drivers. But the economic environment is proving to be an even stronger driver to change, which is bringing the power coercive strategy to the fore. But this has failed to work on its own in the past within the organisation so there is a need for a mixed approach where the normative re-educative approach uses change agents (or champions) to identify needs, suggests solutions and refreeze the change (appendix 3). This is also done through training. The empirical radical approach is not supported since people on their own may not decide to adopt the change.
Tappen et al 2004 look at a number of primary tasks of being a leader. First, a leader sets direction (mission, goals, vision and purpose); second, a leader builds commitment (drives motivation, spirit and teamwork); and finally, a leader confronts challenges (by innovation, change and turbulence). An effective leader acts like one when he recognises the opportunity for leadership all around him (Barr and Dowding, 2008). I will add also that when a leader finds leadership qualities in others, responsibilities can be delegated to such people for their personal development. Walker and Avant (1994) look at different perspectives of describing leadership. Leadership is a position and a process (a functional approach), a characteristic trait and personal quality (based on trait theory), and a power relationship (based on the style or the effect of the leader on group behaviour). Leadership is vital where changes are occurring everywhere. Sofarelli and Brown (1998) criticised the bureaucratic management model of the NHS in favour of a leadership focused health service. Macdonald and Ling (2002) supported this view saying that nurses should develop leadership skills and clinical development in order to help them deal with a rapidly changing situation in clinical care. This change includes my area as well. Rippon (2001) did not seem to agree with Macdonald and Ling stating that training alone will not develop the leadership required to bring about change. The development of growth cultures will create leaders with emotional intelligence focusing on inward (self awareness and the need for learning) rather than outward bound experiences (expected behaviours). Another leadership style I will adopt is that of Tappen et al (2004) above setting direction, building commitment and confronting challenges.
In the past the resistance to change has come from service users, carers and councillors. The political restrainer for change will also be the general elections in May 2010, because Parliamentary members will be preparing for the elections, which slowed down the initial process of decision making. While some sees there will be new opportunities for social workers others feel the profession will be under threat. Some feel social workers will go back to case work with families rather than being gatekeepers rationing resources. While the government has said that it is fully committed to the personalisation agenda, some social care workers and union representatives has raised fears of its effects on disabled people and staff terms and conditions. Social workers can focus on those people who require large amounts of support. A poll carried out by community care in 2008, demonstrates a cool reception to personalisation as the right way forward. Action on Elder Abuse also felt that government was taking the perspective on adult physical disability and applying it without any consideration across the board to people who are in highly vulnerable situations. (Community care, 2009).
It is important for those who require personal support at key junctures to have more support, either through supervision by managers, team leaders, readdressing training needs, ensuring a skills match is conducted to ascertain people are in the right jobs, or given the opportunity to develop their areas of strengths within the change process. Belbin’s nine stage team roles will decide this, where managers can identify strengths and weaknesses within the team, and use this to counterbalance the team. This will also help in reducing resistance to change (Belbin, 1993).
The challenge of the report for the organisation considered external and internal factors in bringing about individualised budgets for service users under the transformation agenda, fundamental changes in staffing arrangements, reducing the current staffing levels, encouraging staff to work in new ways and delivering a modern fit for purpose quality service. This project was researched comparing theories, models and techniques to bring about the desired change in organisational transformation. Examples were sourced from the local authority where I had a previous placement. The key concepts used in the project are leadership, partnership, team working and change management theories derived from national health and social care policies. The organisation heralded its transformation programme in 2007 in response to national policies, and efficiency staff savings. This was in response to global huge pressures on resources, organisations having the potential to advance the quality of people’s lives and ending old ways of funding; the desired option of the organisation is ensuring 50 per cent of service users have SDS by 2011.
I found that the old “club” culture needs to be replaced by a mechanistic organisation which sees tasks allocated, authority delegated, communication channelled and the whole enterprise seen in terms of coordinating and rationing out of work. I project managed this change as it will save money that has been overspent on consultants. Impacts from the external environment are one of the best explanations for a transformation. This can be explained by carrying out a PESTEL and SWOT analysis to consider how the organisation’s strategies fit with its external environment. There is a need for a mixed approach where the normative re-educative approach uses change agents (or champions) to identify needs, suggests solutions and refreezes the change. This is also done through staff training. I will add also that when a leader finds leadership qualities in others, responsibilities can be delegated to such people for their personal development.
I intend to evaluate the success of the project by reviewing key milestones to be achieved. There are various methods that can be used such as SMART (specific, measurable, achievable, and reasonable/relevant and timeframe/timely). The five Ws and H can also be used which is similar to SMART. I will be using a simple system similar to the Gantt chart. This chart will be a useful strategy to ascertain when and whether the desired options are completed. However, this has been modified to simply display a timeframe of when important aspects of the change will be completed. This has been shown in appendix 4, displaying a six month time frame from May 2010 to October 2010. The important landmarks include staff training on the new ways of working, the new introduction of individual budgets for service users, the implementation of the new ways of working and raising stakeholder awareness through conferences and workshops.
- The key recommendations I will proffer are:
- To project manage the work using project management principles rather than expensive consultants.
- To bring about individual budgets for service users, as the best means of empowering them.
- Support staff to work in new ways in order to prepare them for the new era.
- To use management tools to ensure the change such as SWOT and PESTEL analysis, principles of effective team working, effective leadership styles and Lewin’s three –way change process.
- And finally, to evaluate the project using a timetable of activities similar to a GANTT chart.
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PESTEL ANALYSIS OF MY ORGANISATION
|POLITICAL||· New Labour public sector reforms chartering a third way.|
· Led to DH policies such as Valuing people (DH, 2001), Valuing People Now (2007), Our Health, Our Care, Our Say (DH, 2006), Putting People First (2007).
· Change agenda held back due to May 2010 general elections.
· Conservatives traditionally believe in public service cutbacks and privatisation.
|ECONOMIC||· Funding streams to support government agendas such as the Learning Disability Development Fund (LDDF).|
· Major economic downturn and credit crunch since 2008, leading to cutbacks in services.
|SOCIAL||· Ageing population in future (will affect older services).|
· People living longer due to better medical care
· Leading to further strain on scarce resources.
|TECHNOLOGICAL||· development of central data systems such as Framework i|
· Move towards more paperless systems
· Wide scale staff training on use of computers
|LEGAL||Health and Community Care Act 1990|
Appendix 2: The organisation’s SWOT analysis
- Experienced and skilled staff team Too many outside consultants, with ideas
- A number of changes in line with government which were unworkable – leading to financial
Policies already completed wastages
- A mix and variety of skilled staff
- Carers and service users tend to work in good Existence of “club” culture in senior ranks
partnership with staff
Staff beginning to feel demotivated
Good infrastructure ready for change. Staffing reduction may weaken service
New support plans and assessment framework Further cutbacks by new government
Completed to enable development of Privatisation
Work in partnership with others e.g. voluntary sector
APPENDIX 3: the organisation’s change process using lewin’s change model
Appendix 4: Timetable of events
|Review of current support plans||Care managers||June 2010|
|Introduction of individual budgets||Care brokers||August 2010|
|New Ways of Working training completed||Trainers, staff and managers||September 2010|
|Workshops and conferences for stakeholders, completed||Trainers||September 2010|
|Implementation of individual budgets||Social care staff||September 2010|
|Care managers begin to work more on the field||Social workers||October 2010|
|Social care staff begin to work more in the community||Social care staff||October 2010|